ARTHROSIS

ARTHROSIS (syn .: osteoarthritis, osteoarthritis deformans) - a disease of the joints, which is based on degenerative changes of the articular cartilage.

There are primary and secondary osteoarthritis. In the primary causes of osteoarthritis degenerative changes of the articular cartilage is unclear; it is possible that the cartilage metabolism disorders caused by genetically. A special kind of primary osteoarthritis is nodular arthritic joints of the hands.

The main causes of secondary osteoarthritis is an overload of healthy articular cartilage or damage. Overloading of articular cartilage may be due to overweight, shortening one limb, X- and O-shaped shin. Damaged articular cartilage can result from injury, chronic inflammatory processes in the joints (arthritis sm.) system metabolic (e.g. gout) and endocrine (e.g., hypothyroidism) diseases as well as due to congenital dysplasia and disorders of cartilage (Cascina disease - Beck).

Major changes in osteoarthritis occur in the articular cartilage. Microcracks are observed and erosion. Along the edges of the altered cartilage formed bony growths (osteophytes). Over time, in addition to cartilage, and other changes are subject to joint tissue. Because of the small cartilage debris falling into the joint cavity may develop inflammation of the lining (synovial) sheath - synovitis. In the later stages of the disease may be a significant deformity of the affected joint, severe disturbance of its functions.

Osteoarthritis - the most common joint disease. It develops mainly in women aged 45 - 50 years. Most affected metatarsophalangeal joints I toes, knee, hip joints, the distal and proximal interphalangeal joints of the hands, as well as the metacarpophalangeal joints I finger brushes. Joints other fingers are affected much less frequently, and the shoulder, elbow and ankle joints is extremely rare.

The main clinical manifestation is osteoarthritis pain in the joints, which in most cases are of the so-called mechanical rhythm, ie. E. There are at loading and 'fade in resting position. As the disease progresses the pain becomes constant, excruciating. The pain can be combined with tugopodvizhnostyo, quickly passing the motion. Unlike rheumatoid arthritis, symptoms of osteoarthritis increases in the evening. Other symptoms depend on the location of the lesion. Because osteoarthritis is a degenerative, not an inflammatory disease, systemic manifestations are observed.

When nodular osteoarthritis joints of the hands are marked pain and appear dense formation of the size of a pea - nodule distal (Heberden's nodes) and proximal (Bouchard nodules) interphalangeal joints of the hands. On the back surface of the fingers around the nail bed can form dense painful cyst located under the skin and filled with a viscous liquid. In some cases, the affected joints become inflamed, which increases the pain, promotes dysfunction of the fingers and the appearance of flexion contractures.

Osteoarthritis I metatarsophalangeal joint toe is characterized by pain, occurring during exercise (walking, prolonged standing). Persistence of pain, their relationship with physical activity distinguish this disease from gout, which is sometimes confused with osteoarthritis of the localization. Gradually develop limit flexion of the thumb in this joint, is its deformation. Occasionally may occur inflammation of the joints and surrounding bag (bursitis). Often this joint arthrosis is accompanied by deviation of the big toe outward, and other orthopedic anomalies of forefoot (wide flat foot).

Osteoarthritis of the hip joint (coxarthrosis) more frequently than other arthritic joints, caused by abnormalities of the hip joint. Characterized by pain by relying on the leg when walking, limitation of joint mobility. Over time, developing the fixed position of flexion, adduction, and external rotation, there is distortion of the pelvis.

Osteoarthritis of the knee (gonarthrosis) is manifested by pain, occurring when walking, especially on the stairs or on rough terrain, as well as long standing. When gonarthrosis more frequently than in other joints arthritis, there is a crunch during movement; determined by joint swelling, local redness of the skin over it, crepitus in the performance of passive movements.

The diagnosis of arthrosis of any location set on the basis of typical clinical signs and changes in the characteristic X-ray. These include osteosclerosis, osteophytes (bony outgrowths and the edges of the area of ​​the articular surfaces), racemose enlightenment bone in affected joints, joint space narrowing, and others.

Treatment. Radical means of conservative treatment has not been developed. Apply the methods depend on the form of arthrosis, its location and stage of the disease. In secondary osteoarthritis it is very important to early detection and the best possible root causes and risk factors of the disease. If it affects the joints of the lower extremities is necessary to decrease the load on the joints: the exclusion of long stay on his feet, shortening distance, alternating walking and recreation, use of additional support when walking (eg, walking) as well as the normalization of body weight. When I metatarsophalangeal joint arthrosis toe is essential the correct selection of shoe: it must have a wide toe, low and stable heel, leather uppers. The development of the big toe severe strain requires special orthopedic pads or wearing orthopedic shoes.

During periods prescribed gain pain NSAIDs; carry out physiotherapy, topical ointments. In case of synovitis and inefficiency of this therapy is administered intra-articular corticosteroid hormone drugs. Exercise therapy is indicated for osteoarthritis of large joints of the lower extremities outside the period of exacerbation. It is performed only in a lying or sitting position. Arthrosis patients without exacerbation period recommended spa treatment. In some cases, surgical treatment of the affected joints.